SUBJECT:
CHANGES TO CONVERSION PROCESS FOR MC+ CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP)
DISCUSSION:
There will not be a transitional lock-in period for MC+ for Kids applications taken prior to September 1, 2005 and approved after August 28, 2005 where income exceeds 150% but not 225% of the FPL (the new LOC 2). New approvals for LOC 2 where the application date is prior to September 1, 2005, will have MC+ coverage through September 30, 2005. In order to have coverage after September 30, 2005, the premium payment must be received by the Premium Payments Unit.
The attached MC+ for Kids Transition Approval Notice has been revised to reflect this change. Do not use the MC+ for Kids Transition Approval Notice that was attached to IM Memorandum IM-83 08/02/05.
Example:
- Mrs. Jones applies for MC+ for Kids for her 3 children on August 15, 2005. Her gross income is $3,000.00. Mrs. Jones is approved for MC+ for Kids, CHIP 2 on September 14, 2005. As Mrs. Jones applied prior to the date of effective change (September 1, 2005) of the premium requirements, send her the MC+ for Kids Transition Approval Notice and the IM-4(PRM). Fill in the Approval Notice as noted below:
Based on your family size of 04 and monthly income of $3,000.00:
- The child(ren) listed below are approved for MC+ for Kids healthcare coverage from August 15, 2005 through September 30, 2005. No premium payment is required for this coverage period.
Mrs. Jones does not owe a premium for August 15, 2005 through September 30, 2005 for LOC 2. DMS mails an invoice to Mrs. Jones on the day after the approval is entered in IMU5. Access the MPNI screen to view the invoice and premium information.
Mrs. Jones must send her payment to the Premium Payments Unit to have coverage for her children after September 30, 2005. If the payment is received prior to or on September 30, 2005, Mrs. Jones' will have continuous MC+ for Kids healthcare coverage. If the premium is received after September 30, 2005, the children will not be covered from October 1, 2005 through the date the premium is received.
NOTE: Failure to make this “initial” payment for LOC 2 cases will not result in a six month penalty. A family's initial premium payment applies to coverage after September 30, 2005. If the initial payment is not received within 90 days from the date of the first invoice, the case will close for non-payment of premium and no penalty period will be imposed. Once the initial payment is received and the family fails to pay the next invoice, the case will be closed for failure to pay premium and a six month penalty will be imposed (see Manual Section 0920.020.15.05).
For MC+ for Kids applications taken after September 1, 2005, follow instructions in IM Memorandum IM-83 08/02/05.
Appendix D (Manual Section 0900.000.00) and the Income Guidelines for MC+, MAF and Temporary Assistance chart have been updated to reflect the income limits for the revised MC+ for Kids CHIP program.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
- Beginning August 29, 2005, use the MC+ for Kids Transition Approval Notice attached to this memo as the approval letter for any MC+ for Kids case with income above 150% through 225% of the FPL (new LOC 2) eligible for coverage prior to September 1, 2005.
ATTACHMENT:
MC+ for Kids Transition Approval Notice